Sato Hiroyuki, Ota Miho, Kitabatake Ayako, Numata Yuriko, Takahashi Takumi, Tamura Masashi, Nemoto Kiyotaka, Arai Tetsuaki
Doctoral Program in Medical Sciences, Graduate School of Comprehensive Human Science, University of Tsukuba, Tsukuba, Japan.
Department of Psychiatry, Division of Clinical Medicine, Institute of Medicine, University of Tsukuba, Tsukuba, Japan.
Dement Geriatr Cogn Dis Extra. 2024 Sep 9;14(1):81-88. doi: 10.1159/000541092. eCollection 2024 Jan-Dec.
Although the prevalence of Alzheimer's disease (AD) is higher in older people compared to younger people, dementia has also been documented in younger adults. Although early-onset dementia and late-onset dementia had been considered a single disease in pathological investigations, many studies revealed differences in cognitive and neuroimaging changes between them. We evaluated differences in cognitive and neuroimaging changes among the following groups: individuals with early-onset AD (EOAD), late-onset AD (LOAD), early-onset mild cognitive impairment (EOMCI), or late-onset MCI (LOMCI), and healthy controls (HCs).
Patients underwent both a 1.5 Tesla magnetic resonance imaging scan and the Mini-Mental State Examination (MMSE). Differences in regional gray matter volumes and MMSE subscales were investigated among the five diagnostic groups.
Compared to the EOAD group, the LOAD group had significantly higher scores on orientation in place. Compared to the LOMCI patients, the EOMCI patients achieved significantly higher recall scores. The LOAD and LOMC groups showed significant volume reductions in bilateral medial temporal regions compared to the HCs. The EOAD and EOMCI groups did not show significant atrophy of the medial temporal region compared to the HC group.
The hippocampal volume and memory were preserved in the patients with EOMCI or EOAD compared to those with LOMCI or LOAD. These findings may indicate that the distinct and differing patterns of neuropsychological changes between EOAD and LOAD are also common in MCI, which is intermediate between normal cognition and AD.
尽管与年轻人相比，阿尔茨海默病（AD）在老年人中的患病率更高，但在年轻人中也有痴呆症的记录。尽管在病理学研究中早发性痴呆和晚发性痴呆曾被视为单一疾病，但许多研究揭示了它们在认知和神经影像学变化方面的差异。我们评估了以下几组人群在认知和神经影像学变化方面的差异：早发性AD（EOAD）患者、晚发性AD（LOAD）患者、早发性轻度认知障碍（EOMCI）患者、晚发性MCI（LOMCI）患者以及健康对照（HCs）。
患者接受了1.5特斯拉磁共振成像扫描和简易精神状态检查表（MMSE）检查。研究了五个诊断组之间区域灰质体积和MMSE子量表的差异。
与EOAD组相比，LOAD组在地点定向方面的得分显著更高。与LOMCI患者相比，EOMCI患者的回忆得分显著更高。与HCs相比，LOAD组和LOMC组双侧内侧颞叶区域的体积显著减小。与HC组相比，EOAD组和EOMCI组未显示内侧颞叶区域有明显萎缩。
与LOMCI或LOAD患者相比，EOMCI或EOAD患者的海马体积和记忆力得以保留。这些发现可能表明，EOAD和LOAD之间不同的神经心理学变化模式在MCI中也很常见，MCI介于正常认知和AD之间。
